When Pain Relief Backfires: Ramsay Hunt Syndrome after Intra-articular Steroid Injection – A Rare Complication with 6-month Follow-up
Abstract
Introduction: Ramsay Hunt syndrome (RHS) results from reactivation of latent varicella-zoster virus in the geniculate ganglion, typically presenting with otalgia, auricular vesicles, and ipsilateral facial palsy. While systemic immunosuppression is a recognized trigger, RHS following local corticosteroid injection is exceedingly rare. Case Report: We report a 55-year-old woman who developed classical RHS 4 days after ultrasound-guided bilateral intra-articular triamcinolone injections for knee osteoarthritis. She received early oral acyclovir and achieved full recovery within 6 months. Conclusion: This case suggests that even locally administered corticosteroids may precipitate viral reactivation in susceptible individuals. Vigilance for cranial neuropathies after regional steroid procedures is warranted, and prompt antiviral therapy remains essential for optimal outcomes.
Fields of Study & Subjects
Facial Nerve Paralysis Treatment and Research
Orthopedic Surgery and Rehabilitation
Herpesvirus Infections and Treatments
Publication details
- Journal / source
- Journal of Orthopaedic Case Reports
- Publisher
- Indian Orthopaedic Research Group
- Volume
- 16
- Issue
- 2
- Pages
- 55–57
- Publication date
- 1 January 2026
- Language
- EN